Kelly Anne Smith, L.M.T.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

19641 Issued in OR

Practice address

1971 NW Overton St
Alba Massage & Bodywork
Portland, OR 97209-1618

Phone

(503) 734-0973

NPI assigned

Jun 20, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1184074130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1971 NW OVERTON ST",
            "address_2": "ALBA MASSAGE & BODYWORK",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091618",
            "telephone_number": "503-734-0973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1971 NW OVERTON ST",
            "address_2": "ALBA MASSAGE & BODYWORK",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091618",
            "telephone_number": "503-734-0973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELLY",
        "middle_name": "ANNE",
        "credential": "L.M.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "19641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Smith
• Kaylie Aurora Smith, PT,DPT
• Kelly Smith
• Kelly Smith, RDH
• Kelly Smith, MSW
• Kelsie C Smith, CCC-SLP
• Kevin Smith, PHARMD, RPH
• Kevin Smith
• Kevin Ray Smith, MD
• Kimberly Jan Smith, P.T.

• Massage Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.